Consumers, providers and health care purchasers need high-quality information to help them compare and evaluate their health care options. The CAHPS V project will advance the AHRQ CAHPS mission of improving patients' experiences with health care by developing and evaluating strategies for survey measurement, reporting and quality improvement (QI). We propose a 5-year effort to advance the science and practice of patient experience assessment, continue innovation to ensure relevance to health service delivery and implement best survey practices, further the science of reporting, and evaluate CAHPS QI efforts. We will develop program communication strategies, and disseminate and promote use of CAHPS products. In particular, we will develop a survey to assess patient experiences with end-of-life care; develop new items to assess shared decision-making, care coordination, patient engagement, and patient safety; test alternatives to the standard CAHPS modes of data collection), explore the feasibility of administering a short-form survey dividing CG-CAHPS composites among respondents to reduce response burden, elicit stakeholder feedback about the value of different CAHPS supplement item sets, evaluate ?The Your CAHPS Survey? that was designed to help users of the CAHPS surveys compile a survey tailed to their specific needs, and evaluate existing Spanish translations of CAHPS surveys. In addition, we will gather input from stakeholders on best practices for narrative data analysis, develop an approach for using automated Natural Language Processing for analyses of narratives, and construct an algorithm approach to select representative narratives that reflect and illustrate overall provider ratings. Finally, we will evaluate the contribution of patient narratives to quality improvement efforts in hospital care for children, characterize primary care practices use of the CG-CAHPS survey and patient-centered medical home items during PCMH transformation, assess the impact of pay- for-performance for care delivered by primary and specialty care safety net providers on CAHPS survey responses, explore the value of new shared decision-making, patient engagement, communication and patient safety items for QI and identify QI strategies that improve patient experience across various settings. We will also advance analytic methods for CAHPS data. The project team is well suited to achieving the study objectives given its prior accomplishments and established working relationships. The work is innovative and designed to facilitate the use of CAHPS surveys and improve response rates to them, enhance reporting and use of CAHPS survey data, and improve health care QI efforts.